Home Health News

As evidenced by this week’s editorial, there are enough bad players looking to use Medicare to further their own agendas and line their own pockets. This is why it is always a pleasure when we can bring to these pages the story of a person or company making a decision to put the needs of providers and patients ahead of their own.

Frank Giannantonio, founder and president of FGA, Inc., a New Jersey billing and financial consulting firm, has done something we consider gracious. (more…)

by Ed Buckley
with Tim Rowan

Lost revenue and poor compliance go hand in hand. They infiltrate a home health care agency together. Managing revenue cycle means improving compliance as much as it means ensuring complete and accurate billing processes and A/R follow up procedures. (more…)

Analysis

One of the most serious problems plaguing our representative form of government is the uncontrolled “revolving door” between elected and appointed offices and high-salary private industry lobbyist positions. Year after year, individuals do selfish things to make us wonder about the objectivity of all of our elected and appointed officials.

When Paul Ryan (R-WI) included the dissolution of Medicare in his 2012 budget proposal this week, and in doing so proposed an unimaginable windfall for health insurance companies, I wondered whether he is to be the next Washingtonian to enter the revolving door. While I insist on remaining optimistic about his personal integrity until proven otherwise, I remembered one precedent from only eight years ago that shakes my optimism. (more…)

In response to what they consider disturbing mandates issued by Medicaid officials in two states and parts of two others, a collection of home care and hospice industry telephony vendors, providers, technology vendors and state associations has formed a new organization, “The Electronic Visit Verification Standards Workgroup.” The organization’s members believe rules established by Medicaid officials in South Carolina, Tennessee, Florida and Texas infringe on free market trade and will have far-reaching, detrimental consequences should other states follow suit. (more…)

Speculation has run wild for two years about how CMS might change the home care payment system this time. Talk of payment bundling, where hospitals get all the money and dole it out as they see fit, is already appearing as a workshop topic. Rumors about payments going directly to patients have come and gone. All of this precedes any type of formal statement by CMS, MedPAC or Congress.

To help cut through rumors and exaggerations, HCTR is going to take on a study of the Accountable Care Organization (ACO) concept that appeared in outline form in last year’s Patient Protection and Affordable Care Act (ACA). Where facts are available, we will pass them along. Where experts have paved the way before us, we will quote them, interview them, or let them write articles of their own.

This week, we begin with an analysis by longtime student of the way elected and unelected federal employees think, Jeff Lewis. We caught up with the founder and former owner of Lewis, Inc., a Baton Rouge-based home health care software company now a part of HealthCarefirst, to ask whether he is experiencing any degree of withdrawal eight months after leaving the industry that had been his life for over 25 years.

He says he has not returned to health care in any official manner, though he has had a few meetings with providers interested in bringing him on to help shape their future plans. But has not found the right role yet, which he says is no surprise because he sees the approach of a healthcare system that is very different from what we have today. If this paper is any indication then we have to agree.

Never one to mince words, Lewis told us when he offered to write the following article, “In the eight months since I left home care, I can’t say I have looked anyone in the eye who is going to be a part of the future of home care, based on what they tell me they are planning.”

A constant researcher, Lewis’ understanding of what has been presented so far from government and media sources seems to exceed that of many with whom we have spoken or whom we have listened to at conferences. Where specifics are still unknown, he clearly says so. Where well-established patterns from the past are likely to be repeated, he draws some conclusions as to how they will apply to this decade’s developments.

With this article as a starting point, we will hear from other experts in future issues and report on rules as CMS releases them. Your reactions to Lewis’ analysis of the new world of ACOs, and the things home care and hospice providers and their technology vendors can be doing now to prepare, are welcome. (more…)

In parts one and two of this series, we discussed some of the impacts of the Affordable Care Act on home care and hospice providers, evidence that patients truly are being discharged from the hospital at far greater risk of death than they were 10 years ago, and the long list of pros and cons of point-of-care automation. In our final installment, we bring all these things together with a study of the interrelationship between clinical documentation accuracy and the government’s accelerated efforts to stop Medicare and Medicaid fraud and abuse. (more…)

Last week, we cited research indicating patients truly are presenting for admission to home health care services after shorter hospital stays and in far worse health. We argued that Medicare-certified agency competitiveness is better supported by preventing return hospital admissions than by shaving a day off hospital lengths of stay. This week, let’s take a closer look at Computer-Assisted Clinical Documentation Systems. Over the years, certain myths have grown up around point-of-care automation. The best way to attack mythology is with facts. (more…)

Two thousand eleven will be a year characterized in various ways by the home care and hospice community. “Boring” will not be one of them.

The year that welcomes the first Baby Boomers to Medicare will also see:

• the first effects of the Patient Protection and Affordable Care Act (ACA)
• another string of Medicare pay rate cuts for home care
• tighter hospice regulations
• growing impact from private duty agencies
• almost all state Medicaid systems in the red; slashing eligibility, rates and services to cope
• many employers wondering, if the nursing shortage is said to be easing, where they all are
• ongoing, major government crackdown on Medicare fraud that frequently cannot tell the difference between criminal intent and typos (more…)

Home Care Technology Report has learned that HealthCareFIRST, a home care and hospice software and services company based in Springfield, Missouri, has acquired 100% of the stock of CareFacts, Inc., a home care and hospice software vendor in St. Paul, Minnesota. (more…)